站立姿勢與伸手及物對中風患者患側載重之影響

Effect of Standing Postures and Reaching on Weight Bearing of Affected Limb in Post-Stroke Patients

劉秀之(Hsiu-Chih Liu) ； 陳瓊玲(Chiung-Ling Chen) ； 楊國德(Kwok-Tak Yeung) ； 王珩生(Heng-Sheng Wang) ； 郭雪娥(Sheue-Er Guo) ； 游志煌(Chih-Huang Yiou)

《職能治療學會雜誌》 18卷 (2000/09) Pp. 10-18

https://doi.org/10.6594/JTOTA.2000.18.02

摘要

Deficiencies in weight bearing and weight shifting over the affected side are common problems among patients with hemiplegia due to a cerebrovascular accident (CVA), such problems in turn hinder the function of lower extremities profoundly. Clinically, therapists facilitate weight shifting toward the affected side by means of activities that incorporate various standing postures and reaching for objects. The purpose of this study is to examine the effect of four standing postures and reaching for objects on weight bearing of affected limb in CVA patients.
Thirty CVA patients participated in this study. There were 23 males and 7 were females, their average age was 56.59 years. The median interval between onset and investigation was 2 years. Patients were tested randomly in six conditions that included four postures. They were: (a) symmetry standing, (b) stride standing with knee extension of the affected leg, (c) stride standing with knee flexion of the affected leg, (d) step standing, (e) stride standing with knee flexion of the affected leg and reaching an object and (f) step standing and reaching an object. The Balance Performance Monitor was used to measure the weight distribution over the affected side during 30 seconds per testing trial.
The results showed that different standing postures had significant different influences on weight bearing of affected limb (F = 96.90, p ＜ .001) with the exception of the difference between stride standing with knee flexion and stride standing with knee extension (t = -1.524, P = .138). When examining the effects of reaching for objects, significant difference on weight shifting toward the affected side were shown between reaching for objects in step standing posture and simply step standing (t = -4.52, P ＜ .001). There was no significant difference between reaching for objects and not reaching in stride standing with knee flexion condition (t = -2.00, P = .054). Using activities that incorporate stride standing with knee flexion of the affected leg or combining reaching activities are recommended in weight bearing training of patients with CVA.

關鍵字

姿勢控制,伸手及物,患側載重,中風患者

並列摘要

Deficiencies in weight bearing and weight shifting over the affected side are common problems among patients with hemiplegia due to a cerebrovascular accident (CVA), such problems in turn hinder the function of lower extremities profoundly. Clinically, therapists facilitate weight shifting toward the affected side by means of activities that incorporate various standing postures and reaching for objects. The purpose of this study is to examine the effect of four standing postures and reaching for objects on weight bearing of affected limb in CVA patients.
Thirty CVA patients participated in this study. There were 23 males and 7 were females, their average age was 56.59 years. The median interval between onset and investigation was 2 years. Patients were tested randomly in six conditions that included four postures. They were: (a) symmetry standing, (b) stride standing with knee extension of the affected leg, (c) stride standing with knee flexion of the affected leg, (d) step standing, (e) stride standing with knee flexion of the affected leg and reaching an object and (f) step standing and reaching an object. The Balance Performance Monitor was used to measure the weight distribution over the affected side during 30 seconds per testing trial.
The results showed that different standing postures had significant different influences on weight bearing of affected limb (F = 96.90, p ＜ .001) with the exception of the difference between stride standing with knee flexion and stride standing with knee extension (t = -1.524, P = .138). When examining the effects of reaching for objects, significant difference on weight shifting toward the affected side were shown between reaching for objects in step standing posture and simply step standing (t = -4.52, P ＜ .001). There was no significant difference between reaching for objects and not reaching in stride standing with knee flexion condition (t = -2.00, P = .054). Using activities that incorporate stride standing with knee flexion of the affected leg or combining reaching activities are recommended in weight bearing training of patients with CVA.

並列關鍵字

postural control,reaching,weight bearing,post-stroke Patients